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    Understanding Surgical Weight Loss

    Kara Sjogren, DO Deaconess Weight Loss Solutions 08/13/2018
    Weight loss is a popular and important topic. As a physician specializing in helping people lose weight, I’ve seen firsthand how weight loss success positively impacts nearly every aspect of their lives. I have also answered many questions about the surgeries we perform, the process of preparing for surgery, and what patients can expect over the months prior to and after surgery.
     
    In this article, I want to share information about our surgical weight loss program to help anyone curious about the process better understand what we offer at Deaconess Weight Loss Solutions (DWLS).    
     
    Surgical weight loss options

    DWLS offers two types of surgical weight loss: Gastric bypass surgery and sleeve gastrectomy.
    • Gastric Bypass Surgery - Gastric bypass surgery is a highly effective, long-term treatment for morbid  obesity. In this procedure, the surgeon creates a small stomach pouch and attaches a section of the small intestine directly to the pouch. This allows food to bypass a portion of the small intestine.
    • Sleeve Gastrectomy - Sleeve gastrectomy, also called gastric sleeve surgery, is a laparoscopic procedure where a thin, vertical sleeve of stomach is created using a stapling device. The sleeve is about the size of a banana and limits the amount of food you can eat. The rest of the stomach is removed.
     
    How do those procedures help people lose weight?

    Surgical weight loss procedures create weight loss in three ways: restriction, metabolic change and malabsorption.
    • Restriction works by reducing hunger. It’s easier to eat less and control portions. This is done by decreasing the capacity of the stomach, which keeps you from feeling as hungry; less food is more satisfying. Gastric bypass and sleeve gastrectomy both fall into this category.
    • Metabolic changes include improvement—or even resolution—of type II diabetes by improving insulin resistance. The body begins to use glucose more efficiently almost immediately after surgery. Other metabolic changes include improvement of cholesterol, as well as hormone imbalances (such as polycystic ovarian syndrome). Gastric bypass and sleeve gastrectomy both fall into this category.
    • Malabsorption reduces the amount of calories that can be absorbed. Part of the digestive system is bypassed so some calories aren’t absorbed. Gastric bypass falls into this category.
       
    Who should consider surgical weight loss and why?

    Bariatric surgery (surgical weight loss) is an effective way to lose weight and reduce the risk of obesity-related health problems, including diabetes and heart disease. It might be a good choice for you if these statements are true:
    • You are morbidly obese. This means you have a BMI, or body mass index, of at least 40, or a BMI of at least 35 plus an obesity-related disease such as diabetes or high blood pressure.
    • You have tried to lose weight using other methods and they have not worked.
    • You are committed to making the changes necessary for long-term success. Surgery is only the beginning of the weight-loss journey. To lose weight and keep it off — which most bariatric surgery patients are able to do — you will have to commit to making healthy choices.
     
    For many people who are obese, surgery is the most effective way to lose weight and reduce the risk of obesity-related health problems.
     
    What to do first if you are interested in surgical weight loss
    At Deaconess Weight Loss Solutions, our process begins with an informational seminar for basic education and to answer initial questions. After this seminar, you will have a sense of whether weight loss surgery may be right for you. 

    If you decide to become part of our program, you will begin a six-to-nine month pre-surgery journey that includes:
    • Insurance coverage and cost assessment
    • Complete medical evaluation by me, the bariatrician.
    • Treatment of any health conditions found (often working with your primary care doctor)
    • Various evaluations by a dietitian, psychologist and exercise specialist
    • Extensive education process emphasizing a healthier lifestyle
    • Any other requirements based upon your individual needs or insurance

    After those steps are completed, you meet with a surgeon who will perform the bariatric procedures. That doctor conducts an evaluation for surgical risk and benefit, which may require additional testing directly related to the surgery.

    More education, including post-op dietary education and a detailed description of the surgery, will follow. Step-by-step surgical details, including medications, processes, etc. are covered so you feel comfortable with the process and know what happens next. Surgery is scheduled at the completion of this education.
     
    What’s the process once surgery is scheduled?
    • When you are scheduled for surgery, plan to arrive at the hospital the morning of surgery and stay in the hospital for one night for sleeve gastrectomy and two nights for gastric bypass. (This is an average. Those with certain health conditions may need to stay longer.)
    • Most people are able to return to work about 2 weeks after surgery; those who do lifting or more physical work may need a little longer. 
    • After surgery, there is careful follow-up to make sure you are doing well and to guide you through the post-operative diet changes.
    • Regular follow-up visits take place over the next 12 months. After your one-year surgical anniversary, you check in once per year. You will need support between visits to the office so we encourage patients to participate in the post-bariatric surgery support group that meets here at DWLS. 
     
    Is the weight loss permanent?

    Many people wonder about how long weight loss surgery will “work” for them and if weight loss permanent from surgery is permanent.
     
    Surgery is only a small part of the weight loss journey. While the surgery is helpful in reducing the volume of food you can eat, regulating hormones, etc. the lifestyle changes—diet, exercise, spiritual well-being, etc.—impact the ongoing effectiveness of the procedure.

    Good long term results come from education and support prior to and after the surgery. Many studies show that the longer and more involved you are in a program, the better outcomes you’ll see. This is a life-long commitment.

    Will insurance pay for it?

    Bariatric procedures are often covered by insurance. More and more, employers and insurance plans are learning the long-term benefits of surgery—both health and financial—which makes the surgery more available.
     
    Different plans will have different out-of-pocket costs, which is why determining insurance coverage is one of our early steps in the process, so you can make an informed decision.

    For those without insurance coverage for surgical weight loss, we offer financing options.
      
    Join us for the next seminar

    To learn more about Deaconess Weight Loss Solutions, surgical weight loss options, or to register online for one of our upcoming new patient seminars, visit www.deaconess.com/weightloss.
     
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